Editorial: Rebound COVID-19 and Cessation of Antiviral Treatment for SARS-CoV-2 with Paxlovid and Molnupiravir

Parums, Dinah V.

doi:10.12659/msm.938532

Cited by 17 publications

(14 citation statements)

References 13 publications

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“…Some concerns have been recently raised on COVID‐19 rebound in patients treated with antiviral agents 38 . The COVID‐19 rebound is most frequently reported in patients taking nirmatrelvir/ritonavir agents 38 .…”

Section: Discussionmentioning

confidence: 99%

Efficacy and safety of nirmatrelvir/ritonavir (Paxlovid) for COVID‐19: A rapid review and meta‐analysis

Amani

2023

Journal of Medical Virology

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This study aimed to examine the efficacy and safety of nirmatrelvir/ritonavir (Paxlovid) for coronavirus disease 2019 (COVID‐19). PubMed, Cochrane Library, Web of Science, medRxiv, and Google Scholar were searched to identify the relevant evidence up to November 10, 2022. The reference lists of key studies were also scanned to find additional records. The quality of the studies was evaluated using the Cochrane tools for assessing the risk of bias. The Comprehensive Meta‐Analysis software version 3.0 was employed for data analysis. Twenty‐three studies involving 314 353 patients were included in the analysis. The findings of the meta‐analysis showed a significant difference between the Paxlovid and no‐Paxlovid groups in terms of mortality rate (odds ratio [OR] = 0.25; 95% confidence interval [CI]: 0.14–0.45), hospitalization rate (OR = 0.40; 95% CI: 0.24–0.69), polymerase chain reaction negative conversion time (mean difference [MD] = −2.46; 95% CI: −4.31 to −0.61), and hospitalization or death rate (OR = 0.17; 95% CI: 0.06–0.46). However, no significant difference was observed between the two groups in terms of COVID‐19 rebound (OR = 0.84; 95% CI: 0.67–1.04), emergency department visit (OR = 0.75; 95% CI: 0.45–1.24), intensive care unit admission (OR = 0.37; 95% CI: 0.13–1.01), and adverse events (OR = 2.20; 95% CI: 0.42–11.47). The results of the present study support the efficacy and safety of Paxlovid in the treatment of patients with COVID‐19. Further research is needed to investigate the COVID‐19 rebound after Paxlovid treatment.

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Section: Discussionmentioning

confidence: 99%

Efficacy and safety of nirmatrelvir/ritonavir (Paxlovid) for COVID‐19: A rapid review and meta‐analysis

Amani

2023

Journal of Medical Virology

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“…Studies assessing the in vitro antiviral activity of remdesivir, molnupiravir and nirmatrelvir have shown that they remain active against SARS-CoV-2 Omicron and other variants of concern and their target proteins (the viral RNA dependent RNA polymerase and the viral main protease Mpro) are highly conserved [31]. COVID-19 therapeutic monoclonal antibodies lost their efficacy against emerging variants due to mutations in the monoclonal antibody-targeted SARS-CoV-2 spike protein [32].…”

Section: Discussionmentioning

confidence: 99%

The Antiviral Effect of Nirmatrelvir/Ritonavir during COVID-19 Pandemic Real-World Data

Petrakis

Rafailidis

Trypsianis

et al. 2023

Viruses

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Introduction: Vaccination against SARS-CoV-2 and the prevalence of Omicron variants have reduced the risk of the severe clinical progress of COVID-19. However, the risk of breakthrough infections has increased, and early administration of an effective antiviral treatment is significant in order to prevent the severe progression of COVID-19 in vulnerable patients with comorbidities. Patients and methods: Adults with confirmed SARS-CoV-2 infection were included in a matched-pair retrospective study based on age, gender, comorbidities and vaccination status. They were divided into two groups: group A (n = 200) consisted of outpatients at increased risk of severe clinical progress who were treated with nirmatrelvir/ritonavir and group B (n = 200) consisted of non-hospitalized patients who did not receive antiviral treatment. Demographic data, clinical outcome (death, intubation), days of hospitalization, time for recovery, adverse events and treatment compliance were reported. Results: The median age (75.24 ± 13.12 years in the study group and 76.91 ± 14.02 years in the comparison group) and the proportion of males (59% vs. 60.5%, respectively) were similar between the two groups. A total of 6.5% of patients in group A and 10.5% in group B were unvaccinated against SARS-CoV-2. Three patients from group A (1.5%) and one hundred eleven (55.5%) from group B required hospitalization. The duration of hospitalization (3 days vs. 10 days in group B, p < 0.001) and the total time needed for recovery (5 days vs. 9 days, p < 0.001) was shorter in the study group. A rebound of SARS-CoV-2 infection within 8–12 days after diagnosis was documented in 6.5% of patients in group A and 8% of patients in group B. Conclusion: Oral treatment with nirmatrelvir/ritonavir in high-risk non-hospitalized patients was safe and effective in preventing the severe clinical progress of COVID-19 pneumonia. Early administration of antiviral agents in vulnerable outpatients combined with a full vaccination scheme is significant in order to avoid hospitalization and severe clinical outcomes.

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“…Furthermore, COVID-19 rebounds have been reported after cessation of Nirmatrelvir and Molnupiravir treatment, especially in patients with underlying medical conditions ( Parums, 2022 ; Wang, 2022 ). Rates of COVID-19 rebound increased for both drugs with the time after treatments.…”

Section: Direct Antivirals Available For Covid-19 Treatmentmentioning

confidence: 99%

Targeting SARS-CoV-2 and host cell receptor interactions

Lim

2023

Antiviral Research

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Editorial: Rebound COVID-19 and Cessation of Antiviral Treatment for SARS-CoV-2 with Paxlovid and Molnupiravir

Cited by 17 publications

References 13 publications

Efficacy and safety of nirmatrelvir/ritonavir (Paxlovid) for COVID‐19: A rapid review and meta‐analysis

Efficacy and safety of nirmatrelvir/ritonavir (Paxlovid) for COVID‐19: A rapid review and meta‐analysis

The Antiviral Effect of Nirmatrelvir/Ritonavir during COVID-19 Pandemic Real-World Data

Targeting SARS-CoV-2 and host cell receptor interactions

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